Senate Majority Leader Chuck Schumer is pressing ahead with at least part of budget reconciliation bill to salvage some of President Joe Biden’s priorities ahead of the midterms, never mind Mitch McConnell’s threats to take hostages. The bill can pass with just Democratic votes, and has be passed by the end of September with the close of the fiscal year, so time is running out. The first chunk to go to the Senate parliamentarian on Wednesday is on drug pricing.
The provision would allow Medicare to negotiate some prescription drug prices, and apparently has the agreement of all 50 Democrats, Joe Manchin and Kyrsten Sinema included. Between the two of them, they’ve halted progress on Biden’s big “Build Back Better” agenda for the better part of a year. Last fall, Democrats had worked out a compromise solution on the provision.
The new plan is rumored to be pretty much the plan from last fall, allowing negotiation mostly on drugs administered by doctors and hospitals rather than everyday prescriptions, but it is said to include caps on how much Medicare enrollees and people in employer-sponsored health plans have to pay out-of-pocket for drugs. It could also include more help for lower-income seniors to make premiums and co-pays more affordable.
Campaign Action
Progressives, and particularly House Democrats want Medicare to negotiate all drug prices, with the veterans’ health program is allowed to do, but that was a bridge too far for Sinema, in particular. She was initially opposed to any kind of price negotiation on prescription drugs, but eventually came to an agreement with Biden, according to sources, but whether she’ll stick to that agreement all these months later remains to be seen.
If you can believe Manchin, Sinema is on board. Sam Runyon, a spokesman for Manchin, told the Washington Post that Manchin “has long advocated for proposals that would lower prescription drug costs for seniors and his support for this proposal has never been in question. He’s glad that all 50 Democrats agree.” So right now, it appears that Manchin and Sinema haven’t resumed last fall’s whack-a-mole game, where they took turns popping up in opposition to various parts of the plan,
It would seem that’s the case on at least this provision, if Schumer is confident in sending it on to the parliamentarian, Elizabeth MacDonough. That’s the Senate employee who has been treated as some kind of oracle, the staff her determines if provisions fit under the strict spending and revenue restrictions the process includes. Or at least, that’s what she’s supposed to be doing, though not all of her rulings appear to be simple objective calculations and sometimes tend to the politicized policy-making side. It’s important to note as always that she can be overridden by the Senate. Her word isn’t law, even though Democrats have shown a reluctance to buck her pronouncements.
While the drug price negotiation part of it is apparently worked out, the looming disaster of the Obamacare cost cliff is still under negotiation. The problem is that the increased subsidies provided by last year’s American Rescue Plan are expiring, and 13 million people are going to be looking at much higher premiums next year if the program isn’t continued. Millions of those won’t be able to afford their insurance and will join the ranks of the uninsured.
It took a while for Manchin to acknowledge that this is an issue they need to deal with, and when he finally got there, he spouted nonsense. Asked about it, he gave his knee-jerk response to any kind of policy proposal that helps people: it has to be means-tested. Which it already is, and has been all along. Manchin, or his staff, finally realized they stepped in it with that one, and are getting just a little bit defensive on it.
“He understands the ACA,” someone “familiar with Manchin’s thinking” told NBC News. “He’s campaigned on it.”
He doesn’t understand the ACA, but at least he’s finally paying attention to the fact that it’s a big problem for Democrats ahead of the midterms.
RELATED STORIES